CHAPTER V

ANATOMY AND PHYSIOLOGY

The word skeleton comes from the Greek word meaning dried- up body, our internal
framework is so beautifully designed and engineered and it puts any modern skyscraper to
shame. Strong, yet light, it is perfectly adapted for its functions of body protection and motion.
Shaped by an event that happened more than one million years ago when a being first stood
erect on hind legs our skeleton is a tower of bones arranged so that we can stand upright and
balance ourselves. The skeleton is subdivided into two divisions: the axial skeleton, the bones
that form the longitudinal axis of the body, and the appendicular skeleton, the bones of the limbs
and girdles. In addition to bones, the skeletal system includes joints, cartilages, and ligaments
(fibrous cords that bind the bones together at joints). The joints give the body flexibility and allow
movement to occur. Besides contributing to body shape and form, or bones perform several
important body functions such as support, protection, movement, storage and blood cell
formation.
The femur, or thigh bone, is the longest, heaviest, and strongest bone in the entire
human body. All of the bodys weight is supported by the femurs during many activities, such as
running, jumping, walking, and standing. Extreme forces also act upon the femur thanks to the
strength of the muscles of the hip and thigh that act on the femur to move the leg. The femur is
classified structurally as a long bone and is a major component of the appendicular skeleton.
The femur, or thigh bone, is the only bone in the thigh. Its proximal end has a ball-like
head, a neck, and greater and lesser trochanters (separated anteriorly by the intertrochanteric
line and posteriorly by the intertrochanteric crest). The trochanters, intertrochanteric crest and
the gluteal tuberosity, located on the shaft, all serve us sites for muscle attachment. The head of
the femur articulates with acetabulum of the hip bone in a deep, secure socket. However, the
neck of the femur is a common fracture site, especially in old age.
The femur slants medially as it runs downward to joint with the leg bones; this brings the
knees in line which the bodys center of gravity. The medial course of the femur is more
noticeable in females because of the wider female pelvis. Distally on the femur are the lateral
and medial condytes, which articulates the tibia below. Posteriorly, these condytes are
separated by the deep intercondylar notch. Anteriorly on the distal femur is the smooth patellar
surface, which forms a joint with the patella, or kneecap.
The main function of the femur is to transmit forces from the tibia to the hip joint. It acts
as the place of origin and attachment of many muscles and ligaments so we shall split it into
three areas; proximal, shaft and distal.
A. Proximal
The proximal area of the femur forms the hip joint with the pelvis. It consists of a head
and neck, and two bony processes called trochanters. There are also two bony ridges
connecting the two trochanters.
1. Head Has a smooth surface with a depression on the medial surface this is for the
attachment of the ligament of the head. At the hip joint, it articulates with the acetabulum
of the pelvis.
2. Neck Connects the head of the femur with the shaft. It is cylindrical, projecting in a
superior and medial direction this angle of projection allows for an increased range of
movement at the hip joint
3. Greater trochanter this is a projection of bone that originates from the anterior shaft,
just lateral to where the neck joins. It is angled superiorly and posteriorly, and can be
found on both the anterior and posterior sides of the femur. It is the site of attachment of
the abductor and lateral rotator muscles of the leg

4. Lesser trochanter much smaller than the greater trochanter. It projects from the
posteromedial side of the side, just inferior to the neck-shaft junction. The psoas major
and iliacus muscles attach here.
5. Intertrochanteric line a ridge of bone that runs in a inferomedial direction on the
anterior surface of the femur, connecting the two trochanters together. The iliofemoral
ligament attaches here a very strong ligament of the hip joint. After it passes the lesser
trochanter on the posterior surface, it is known as the pectineal line.
6. Intertrochanteric crest similar to the intertrochanteric line, this is a ridge of bone that
connects the two trochanters together. It is located on the posterior surface of the femur.
There is a rounded tubercle on its superior half, this is called the quadrate tubercle,
which is where the quadratus femoris attaches.

B. The Shaft
The shaft descends in a slight medial direction. This brings the knees closer to the
bodys center of gravity, increasing stability.
On the posterior surface of the femoral shaft, there are roughened ridges of bone, these
are called the linea aspera (Latin for rough line)
Proximally, the medial border of the linea aspera becomes the pectineal line. The lateral
border becomes the gluteal tuberosity, where the gluteus maximus attaches.
Distally, the linea aspera widens and forms the floor of the popliteal fossa, the medial
and lateral borders form the the medial and lateral supracondylar lines. The medial
supracondyle line stops at the adductor tubercle, where the adductor magnus attaches.

C. Distal
The distal end is characterised by the presence of the medial and lateral condyles, which
articulate with the tibia and patella, forming the knee joint.
1. Medial and lateral condyles rounded areas at the end of the femur. The posterior and
inferior surfaces articulate with the tibia and menisci of the knee, while the anterior
surface articulates with the patella.
2. Medial and lateral epicondyles bony elevations on the non articular areas of the
condyles. They are the area of attachment of some muscles and the collateral ligaments
of the knee joint.
3. Intercondylar fossa A depression found on the posterior surface of the femur, it lies in
between the two condyles. It contains two facets for attachment of internal knee
ligaments.
4. Facet for attachment of the posterior cruciate ligament found on the medial wall of
the intercondylar fossa, it is a large rounded flat face, where the posterior crucitate
ligament of the knee attaches.
5. Facet for attachment of anterior cruciate ligament found on the lateral wall of the
intercondylar fossa, it is smaller than the facet on the medial wall, and is where the
anterior cruciate ligament of the knee attaches.

The Steinmann Pin is a metal rod for the internal fixation of fractures commonly used in
orthopedic surgery. It is similar to K-Wire but with larger diameters. Modern Grinding can
custom manufacture Steinmann Pins to your preference.
Processes we have performed on Steinmann Pins includes (but is not limited to) laser
marking, passivation, deburring, tip grinding, and custom thread grinding. We are able to
manufacture custom thread lengths and tip geometries including diamond tips, trocar tips and
tips with angles outside of the standard 15 degrees. We typically manufacture stainless steel
Steinmann Pins but we can also do nitinol.
Modern Grinding can customize wires from 1.6mm up to 4.8mm with lengths of up to 24
inches.
Modern Grinding Steinmann Pins have been used for the medical device industry and
the veterinary industry. They are commonly also referred to as intramedullary pins, the term is
interchangeable. These types of pins are typically used to hold large bone fractures in place